玉泉丸合雷公藤多甙对2型糖尿病肾病的疗效及血清相关因子水平的影响

Efficacy of Yuquan pill combined with Tripterygium glycosides for the treatment of type 2 diabetic nephropathy and its effect on levels of related serum cytokines

目的探讨玉泉丸合雷公藤多甙治疗2型糖尿病肾病的疗效及对血清炎症细胞因子、血管内皮生长因子(VEGF)、胰岛素样生长因子(IGF-1)水平的影响。方法选取黑龙江中医药大学佳木斯学院附属医院和佳木斯市中医院2016年1月至2017年8月收治的2型糖尿病肾病患者100例,以随机数字表法分为对照组(50例)和观察组(50例),分别给予舒洛地特(葡糖醛酸基葡糖胺聚糖硫酸盐)单用治疗和在此基础上加用玉泉丸合雷公藤多甙治疗。治疗8周进行疗效的评定,比较两组患者的近期疗效、治疗前后中医证候评分、肾功能指标、血脂指标、炎症细胞因子[高敏C反应蛋白(hs-CRP),白细胞介素(IL)-8]、VEGF、IGF-1水平及不良反应发生率。结果治疗8周后,观察组近期总有效率、中医证候评分、肾功能指标、血脂指标、hs-CRP、IL-8、VEGF及IGF-1水平均显著优于对照组(P均<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论在常规干预的基础上,采用玉泉丸合雷公藤多甙治疗2型糖尿病肾病可有效保护肾功能,改善血脂代谢的失衡,调节炎性细胞因子、VEGF及IGF-1水平,且安全性良好。

Objective To investigate the efficacy of Yuquan pill combined with Tripterygium glycosides for the treatment of type 2 diabetic nephropathy and its effects on the levels of serum inflammatory cytokines,vascular endothelial growth factor（ VEGF） and insulin-like growth factor-1（ IGF-1）. Methods A total of 100 patients with type 2 diabetic nephropathy treated in Affiliated Hospital to Jiamusi College of Heilongjiang University of Chinese Medicine and Jiamusi Hospital of Chinese Medicine from January 2016 to August 2017 were selected as research objects. The patients were divided into two groups（ n = 50 each） ： control group and observation group according to random digital table method.Sulodexide（ glucuronan glycosaminoglycan sulfate） alone was given in control group,and Yuquan pill combined with Tripterygium glycosides was given on the basis of the same treatment as the control group. Assessment of efficacy was conducted eight weeks after treatment. Short-term efficacy,Traditional Chinese Medicine syndrome score before and after treatment,renal function indexes,blood lipid indexes,levels of serum inflammatory cytokines[hypersersitive C-reactive protein（ hs-CRP）,interleukin（ IL）-8 ],VEGF and IGF-1 and incidence of adverse reactions between two groups were compared. Results Eight weeks after treatment,short-term total effective rate,Traditional Chinese Medicine syndrome score,renal function indexes,blood lipid indexes and levels of serum hs-CRP,IL-8,VEGF and IGF-1 in observation group were better than those in control group（ all P〈0. 05）. There was no significant difference in incidence of adverse reactions between two groups（ P〈0. 05）. Conclusion On the basis of conventional intervention,Yuquan pill combined with Tripterygium glycosides for the treatment of type 2 diabetic nephropathy can effectively protect renal function,improve the imbalance of blood lipid metabolism,adjust the levels of inflammatory cytokines,VEGF and IGF-1,and has good security.